Possible Causes for Sudden Increased Confusion in a Person with Dementia

• Electrolyte disturbances, especially dehydration, sodium (sodium) imbalance, and thyroid problems

• Medical issues such as low blood pressure, low levels of oxygen in the blood, high fever, etc.

• Drugs, including any new medications, increased dosages, drug interactions, over-the-counter drugs, alcohol, etc.

• Lack of drugs, such as stopping use of long-term sedatives (including alcohol and sleeping pills) or having pain that is poorly controlled

• Infection, especially urinary or respiratory tract infection

• Reduced sensory input, such as poor vision or hearing

• Intracranial, such as a brain infection, hemorrhage, stroke, or tumor (rare)

• Urinary or fecal problems, such as not being able to urinate or have a bowel movement

• Myocardial (heart) and lungs, such as heart attack, problems with heart rhythm, worsening of heart failure or chronic obstructive lung disease

• Change in environment, such as hospitalization, travels out of town, facility placement

• Use of anesthesia and other hospitalization related issues. An international study done at the University of Florida found that one in 10 patients 60 and older suffered some memory loss and a lack of concentration for three months following major surgery with general anesthesia lasting two hours or longer. “The exact cause may be very complex,” Gravenstein said. “The anesthetic, other drugs and the specific operation could all play a role.”

• Too little stimulation of the senses, especially in people who already have some degree of mental impairment. In one study, delirium after an operation occurred twice as often in patients in intensive care units without windows as in patients in similar units with windows.

Any sudden change in an older person's behavior should be considered as possible delirium (which is generally temporary) until examination or testing proves otherwise.

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